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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JACK GUO
NPI 1669110599
Dentist - Endodontics in O Fallon, MO

Active since May 20, 2022PECOS Enrolled
113 CHURCH ST, O FALLON, MO 63366(636) 362-4040 Get Directions Write a Review

NPPES record last updated: July 16, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 16, 2026, May 20, 2022 (2 updates tracked since 2022).

About Jack Guo NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK GUO (NPI 1669110599) is an individual endodontics provider in O Fallon, Missouri, licensed in Missouri (2024015466) and active in the NPI registry since May 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669110599
Entity TypeIndividualMale
Primary Taxonomy1223E0200X
Provider Legal NameJACK GUO
Location Address113 CHURCH STO Fallon, MO 63366-2894
Mailing Address2220 Mid Rivers Place Dr Apt 2220Saint Peters, MO 63304-4438 · (870) 404-8258
Phone(636) 362-4040
Sole ProprietorYes
Enumeration DateMay 20, 2022
Last NPPES UpdateJuly 16, 20262 updates tracked since enumeration
NPPES CertifiedJuly 16, 2026
✔ NPI 1669110599 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · EndodonticsDental Providers
Taxonomy Code1223E0200X
License✔ Licensed in MO · 2024015466
Definition
The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.
113 CHURCH ST, O Fallon, MO 63366
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack Guo is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63366 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$69.50 typical visit price
range $17.76 – $137.92
Typical copayment $17.37 (range $4.44 – $34.48)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RIVER CITY ENDODONTICS
Dentist (Endodontics)
113 CHURCH ST
O FALLON, MO 63366
St. Charles County (636) 362-4040

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Guo's NPI number?

The NPI number for Jack Guo is 1669110599. It was assigned to this individual provider in the NPPES registry on May 20, 2022.

Where is Jack Guo located?

Jack Guo practices at 113 Church St, O Fallon, MO 63366. The listed phone number is (636) 362-4040.

What is Jack Guo's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

Is Jack Guo enrolled in Medicare?

Yes. Jack Guo is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jack Guo was last updated on July 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 28 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.